CAJ | 학술논문

目的探讨脊髓型颈椎病患者核磁共振(magnetic resonance imaging,MRI) T2加权像高信号反映病情严重程度及外科预后的可能性.方法我院骨科2005年9月-2009年6月116例脊髓型颈椎病患者纳入此次研究,所有患者均进行颈椎后路减压手术.术前均进行MRI检查.依据MRI T2加权像出现的高信号强度分为3级.0级:未出现脊髓高信号;1级:轻度高信号(信号模糊);2级:高亮度信号(信号高亮).采用日本矫形外科学会(Japanese Orthopaedic Association,JOA)制定的脊髓功能评分标准进行术前术后病情评分.结果0级40例;1级47例;2级29例.病程:0级(11.2±25.6)月,2级(36±33.7)月.术前3等级JOA脊髓功能评分差异无统计学意义,但0级术后JOA评分最高为15.6±1.7,术后改善率最高为65.1±24.3;3级术后JOA评分最低为10.6±2.0,术后改善率最低为36.1±30.3.结论脊髓型颈椎病患者术前MRI T2加权像高信号与患者年龄、病程、术前JOA评分及术后JOA评分相关,MRI T2加权像信号强度最高的患者术后改善率最低,T2高信号的分级方法可作为评价脊髓型颈椎病预后的一个指标.
목적탐토척수형경추병환자핵자공진(magnetic resonance imaging,MRI) T2가권상고신호반영병정엄중정도급외과예후적가능성.방법아원골과2005년9월-2009년6월116례척수형경추병환자납입차차연구,소유환자균진행경추후로감압수술.술전균진행MRI검사.의거MRI T2가권상출현적고신호강도분위3급.0급:미출현척수고신호;1급:경도고신호(신호모호);2급:고량도신호(신호고량).채용일본교형외과학회(Japanese Orthopaedic Association,JOA)제정적척수공능평분표준진행술전술후병정평분.결과0급40례;1급47례;2급29례.병정:0급(11.2±25.6)월,2급(36±33.7)월.술전3등급JOA척수공능평분차이무통계학의의,단0급술후JOA평분최고위15.6±1.7,술후개선솔최고위65.1±24.3;3급술후JOA평분최저위10.6±2.0,술후개선솔최저위36.1±30.3.결론척수형경추병환자술전MRI T2가권상고신호여환자년령、병정、술전JOA평분급술후JOA평분상관,MRI T2가권상신호강도최고적환자술후개선솔최저,T2고신호적분급방법가작위평개척수형경추병예후적일개지표.
Objective To study the clinical value of increased signal intensity (ISI) on MRI T2-weighted images for the severity of symptoms and surgical outcomes in patients with cervical spondylotic myelopathy (CSM). Methods One hundred and sixteen patients admitted to our department from September 2005 to June 2009 were enrolled in this study. The patients underwent MRI before cervical posterior laminoplasty and classified into grade 0 with no ISI, grade 1 with light (obscure) ISI, and grade 2 with intense (bright) ISI. The severity of CSM was scored according to the Japanese Orthopedics Association (JOA) criteria for CSM. Results Of the 116 CSM patients, 40 were classified as grade 0, 47 as grade 1, and 29 as grade 2. The disease course was (11.2±25.6) months and (36±33.7) months for grade 0 and grade 2 patients, respectively. No significant difference was found in the CSM score of grades 1-3 patients according to the JOA criteria. The lowest and highest scores of grade 0 patients were significantly higher than those of grade 3 patients before and after operation ((15.6±1.7) vs (10.6±2.0), (65.1±24.3) vs (36.1±30.3)). Conclusion ISI on T2-weighted MRI in CSM patients before operation is correlated with their age, disease course, preoperative and postoperative CSM score according to the JOA criteria. The improvement rate is the lowest for patients with the highest ISI after operation. Classification of ISI on T2-weighted MRI can be used as an indication for the prognosis assessment of CSM patients.